November 2007 – Enclosure 09
Information Management and Technology
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TABLE OF CONTENTS
1.0 Introduction 4
1.1 Strategic drivers and Context 4
2.0 Strategic Vision for IM&T 8
2.1 Electronic care records 8
2.2 Clinical and business information systems 8
2.3 Using IM&T to improve efficiency and effectiveness 8
2.4 Service user and public involvement 9
2.5 Infrastructure 9
3.0 Key aims for IM&T in North Staffordshire 10
3.1 Keeping up with national programmes 10
3.2 Developing our Provider 10
3.3 Delivering our role as commissioner 10
3.4 Value for Money 10
3.5 Taking advantage of technology 11
3.6 Developing our staff 11
3.7 Realising the benefits 11
4.0 The National Strategy 12
4.1 National Programme for IT (NPfIT) 12
4.2 Operating Framework for 2007/8 12
5.0 North Staffordshire Health Community Strategy 14
5.1 Proposed Structure 14
6.0 Connecting for Health 15
6.1 NCRS - Lorenzo 15
6.2 Child Health System 18
6.3 Picture Archiving and Communications System (PACS) 18
6.4 Choose and Book 19
6.5 Electronic Transfer of Prescriptions 19
6.6 Clinical Record Summary 20
6.7 Prison Health 21
6.8 Secondary Uses Service 21
6.9 Registration Authority 22
6.10 Portal 22
6.11 NHS mail 22
7.0 PCT Provider Services systems 23
7.1 Performance and Marketing Information 23
7.2 Current reporting 23
7.3 Drivers for change 24
8.0 Primary Care Contractor Systems 25
8.1 General Practice Systems 25
9.0 PCT Corporate Systems 27
9.1 Electronic Staff record (ESR) 27
10.0 Information Governance 28
10.1 Information Governance Toolkit 28
10.2 Document and Records Management 28
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10.3 Meeting Data Quality standards 29
10.4 CBSA – Commissioning Business Support Agency 30
11.0 Joint Working with the County Council 31
12.0 Resources 32
12.1 Financial Investment 32
12.2 North Staffordshire IT and Health Intelligence Services 32
13.0 Future Work Plans 33
14.0 Summary 34
Appendix 1 – GP Systems and Suppliers 35
Appendix 2 – 2007 – 2008 Financial Summary 36
Appendix 3 – IT Systems 38
Appendix 4 – Timeline for National Programme developments and likely 49
impact on North Staffordshire PCT
Appendix 5 – Glossary 51
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1. 0 INTRODUCTION
1.0.1 Information is a vital asset for the PCT, supporting both day to day clinical
operations and the effective management of services and resources. This strategy
describes the PCT’s vision and strategic direction for information management and
technology developments for the period 2007-11.
1.0.2 The PCT requires accurate, timely and relevant information to enable it to deliver
the highest quality health care and to operate effectively as a modern and effective
public sector organisation responsible for the health of individuals. Having accurate
relevant information available at the time and place where it is needed, is critical in
all areas of the PCT’s business and plays a key part in corporate and clinical
governance, strategic risk, service and workforce planning and performance
1.0.3 This strategy describes the strategic drivers and context within which it must
operate, considers the impact of Connecting for Health (CfH) and the National
Programme for IT (NPfIT), the data required, the information systems needed to
deliver the data and the technical infrastructure, governance arrangements and the
1.0.4 The PCT plans to exploit the benefits of recent computer application development
which has now reached the stage where the majority of many “information rich”
processes can be proactively supported using electronic systems.
1.1 STRATEGIC DRIVERS AND CONTEXT
1.1.1 Policy environment
There are a range of national policy and strategic drivers which require strategic
IM&T developments and / or robust IM&T support to ensure effective
implementation and delivery.
1.1.2 In 2000, the NHS Plan described the 10 year NHS development strategy. It set out a
programme of investment and reform to transform services to make them more
responsive to patients and deliver the best possible care for the population within
available resources. It proposed developments for increased capacity, improved
standards, reduction in waiting times, increased investment, changes to staff terms
and conditions, encouragement of local autonomy, closer working with social care
and greater involvement of patients.
1.1.3 The Operating Framework for 2007/8 describes the “second phase of reform” and
emphasises more choice and voice for patients, more diverse providers, financial
incentives to ensure best value, more national standards and regulation and
“sustained focus on information management and technology to underpin reforms
and deliver better, safer care”. Specific priorities for 2007/8 are “18 weeks to
treatment”, reducing rates of MRSA, reducing health inequalities and promoting
health and well being and achieving financial balance.
1.1.4 The current national NHS objectives which directly impact on the business of the PCT
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Improving and protecting the health of the population, with special attention to
the needs of the poorest and those with long-term conditions
Increasing choice of providers of acute care and in long term care, appointments
and treatment regimes
improving access and responsiveness in primary and urgent care
shifting more services from secondary to primary care settings
speeding up access to hospital care
delivering effective medicines management
implementing the new Mental Health Act
changes to financial arrangements including the introduction of Payment by
Results and Practice-based Commissioning
1.1.5 The most significant IM&T driver for this strategy is the National Programme for IT
which aims to bring modern computer systems and an integrated IT infrastructure to
transform patient care and services.
1.1.6 The White Paper, “Our health, our care, our say”, published in 2006, describes a new
direction for community services. It has four central aims which have particular
relevance to those with longer-term health conditions. They seek to ensure:
better health and well-being
convenient access to high-quality services
support for those in greatest need
care in the most appropriate setting, closer to home
1.1.7 These re-emphasise the NHS objectives but with the expectation of these being
delivered in an integrated way between health (in both primary and secondary care),
social care and other statutory and voluntary agencies.
1.1.8 The introduction of Practice Based Commissioning (PBC) has resulted in
commissioning decisions and budgets being devolved to groups of GP practices. PBC
will require their having a strong focus on understanding service users’ needs, where
these can best be addressed and reasons for referrals into secondary care, the
effectiveness of those referrals and the associated costs. PBC drives up demand for
timely and accurate healthcare activity data.
1.1.9 The introduction of Payment by Results (PbR) will ensure that funds follow the
choices made by patients and hence that trusts are paid for the activity they
1.1.10 National performance assessments
In 2006, the Healthcare Commission (HCC) began “Annual Health Checks” to review
the performance of PCTs and Trusts and to provide assurance that basic core
standards are being met, improvements made and that services provide value for
1.1.11 The HCC uses a variety of data to assess or validate PCT performance:
trusts are required to declare their performance on 24 core standards
(“Standards for Better Health”) with the HCC using over 2000 pieces of data to
cross check the validity of declarations
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existing and new national targets are generally based on numeric or descriptive
service reviews and national studies typically use a range of data from both new
and existing data sources
1.1.12 PCT’s use of resources is assessed by the Audit Commission’s ALE assessment which
is based on financial reporting, management and standing as well as internal
controls and value for money.
1.1.13 These two assessments provide an integrated approach is more stringent than that
previously adopted and requires robust, consistent reporting across all areas of
activity and performance. The current infrastructure needs strengthening to ensure
accurate and timely data recording and collation in all areas.
1.1.14 Performance management framework
The PCT’s Performance Management Framework describes the approach being
taken to ensure performance improvement. IM&T is key to this process, both as
holders of the data held in operational systems and as developers and publishers of
performance indicators. This involvement is expected to increase during the life
time of this strategy particularly as the PCT develops as a Strategic Commissioning
organisation and Practice Based Commissioners take on additional responsibilities.
1.1.15 Information Governance
“Information Governance” assures the confidentiality, availability, integrity and
protection of information (patient, staff, financial, organisational, paper or
electronic). PCTs are required to annually assess and improve their performance
against 60 “best practice” standards. The assessment is also used by the HCC to
validate other declarations and therefore is a high priority for the IM&T Strategy. A
social care information governance self assessment is also proposed.
1.1.16 Transformational Government
Over the last 5 years, the Government has implemented a number of targets relating
to making a range of government services available electronically and ensuring inter-
operability and data exchange between government systems.
1.1.17 In 2005, the Government established the “Transformational Government”
programme which describes transforming government through technology and
making government transformational through the use of technology. Connecting for
Health is seen as one component of this vision.
1.1.18 Other drivers
Responsibility for prison health care passed to PCTs in 2006 to ensure that prisoners
received the same quality and range of health services as the general population.
1.1.19 North Staffordshire PCT will provide the appropriate technology and information to
support its key objectives and its business plan. This includes the core aims as set
out in the LDP. The strategy will be flexible enough to deliver the building blocks for
improvement to services and adapt to new policies as set out by the PCT, the
department of Health and the government.
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1.1.20 The strategy has a number of themes. These are the local strategic context which
will give the local flavour to the plans, the commitment to the NHS and North
Staffordshire strategies and how they influence local working, the local position with
regard to systems and technology, the opportunities to further exploit technology
and the need for further joint working with partners in particular the Staffordshire
County Council. The strategy also refers to the need for an Information &
Knowledge management strategy for the PCT and discusses the direction of business
1.1.21 North Staffordshire PCT has recently begun to restructure and reassess its delivery
mechanisms. The roles of commissioner and provider are to become more distinct.
The PCT has clear delivery roles with regard to IM&T as a provider but also has a
wider brief as commissioner. The strategy covers both roles as an integrated
1.1.22 The background
North Staffordshire PCT and its predecessor organisations (Newcastle and
Staffordshire Moorlands PCT’s) have been working in line with the National
Programme for IT (NPfIT) for a number of years. The National Care Record Service
(NCRS) system offered is the Computer Services Corporation Alliance’s (CSCA)
‘Lorenzo’ product the rollout of which began in 2005. The programme to bring all
community services onto the system continues until 2008. The GP Practices within
North Staffordshire use a combination of 3 IT system suppliers as follows:
EMIS LV 21
EMIS PCS 7
1.1.23 The descriptions in Section 7 describe where North Staffordshire PCT is starting from
and where it now needs to go to achieve the overall aims.
1.1.24 The key objectives of this strategy link closely to the LDP, Corporate objectives and
the programme of work generated from the Fitness for Purpose review.
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2.0 STRATEGIC VISION FOR IM&T
2.0.1 In response to the strategic drivers outlined in chapter 2, a strategic vision for IM&T
over the period 2007 – 2011 has been developed.
2.0.2 It is planned that by 2011, the majority of clinical and business data will be held
2.1 ELECTRONIC CARE RECORDS
2.1.1 There will be a single corporate patient information system which will:
hold the majority of clinical notes and act as the PCT primary “Patient Master
proactively support agreed Care Pathways
include increased recording of interactions with service users, both for activity,
contacts and information dissemination
have a facility for using electronic tools such as on-line assessments
have a facility to electronically store information received from other agencies
whether received in paper or electronic format
exchange information with national / approved NHS other partner agencies
exchange information with specialist or departmental systems holding service
systems will be able to generate warnings and alerts automatically to direct
clinicians to follow best clinical practice, clinical guideline etc
2.2 CLINICAL AND BUSINESS INFORMATION SYSTEMS
2.2.1 All clinical and business information systems will:
be able to exchange information with other systems, internal or external to the
have appropriate confidentiality controls enabling easy access to relevant
information for authorised users and preventing unauthorised access
only permit access to information on a “need to know” basis, based on role
based access security models
be easy to use for both regular and intermittent users
hold data in a format suitable for both NHS and social care requirements
2.3 USING IM&T TO IMPROVE EFFICIENCY AND EFFECTIVENESS
2.3.1 In order to support the management and operations of the PCT:
business processes will be supported by electronic systems such as document
management, electronic diaries etc
data needed to manage and monitor PCT performance, internally and externally,
will be extracted automatically from operational systems
electronic business and e-procurement will be implemented where possible
performance indicators will be widely available and in a format appropriate for
the user, with their content targeted to appropriate levels
technology will be used to collect information, such as through the use of bar
codes, voice recognition, touch screens etc
the PCT intranet/portal will be used as the primary internal source of
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a wide range of information about the PCT, its population, its range of services,
health conditions, treatments etc will be made available on the PCT portal/web
2.4 SERVICE USER AND PUBLIC INVOLVEMENT
2.4.1 In order to support service user and public involvement in their own care and the
service users will be facilitated to access electronic systems through secure PC
service users will be encouraged to use my Healthspace
on-line feedback mechanisms will be established for formal consultation
HealthSpace is a secure website where patients can store their personal health
information online, such as height, weight and blood pressure. It is a free service
which is available now for all NHS patients living in England aged 16 and over.
It will soon be possible to register to use HealthSpace to view your Summary Care
Record as part of the CRS implementation.
2.5.1 This vision will require a robust technical infrastructure, based on:
every member of staff having ready access to a networked PC at (or very
close to) their place of work
PCs being suitable for staff members’ specific needs
staff being able to securely access systems remotely from other sites (both
PCT and elsewhere) using PCs or roaming devices
every PCT site being securely connected to the corporate network by a
resilient data link with sufficient capacity for business purposes and with a
back-up line in case of failure
the PCT corporate network being connected to the national NHS
infrastructure network by a resilient data link with sufficient capacity for
sharing voice and data networks where it is technically sound and financially
robust information governance arrangements being in place to ensure that
all types of information held are kept confidential, and are accurate, timely,
available wherever and whenever they are needed, with appropriate
disaster recovery and business continuity arrangements
all data held being protected from accidental or deliberate loss or corruption
information systems and infrastructure being available 24/7
staff at all levels having competence and confidence to use both information
and systems in their day to day role
making use of national systems and services where they are cost-effective
and fit for purpose
systems being technically linked and able to exchange data and messages,
through both electronic messaging and shared data input
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3.0 KEY AIMS FOR IM&T IN NORTH STAFFORDSHIRE
3.1 KEEPING UP WITH NATIONAL PROGRAMMES
The first objective of a local strategy is to recognise the national strategy for IT
(NPfIT) and assure the Board that North Staffordshire PCT will fully participate in it
and deliver the key programmes at local level.
3.2 DEVELOPING OUR PROVIDER
A key objective for the Provider Arm is to make use of relevant national applications
and integrate local legacy systems with a view to delivering the full electronic
patient record for the provider services with the facility to upload summary data as
required to the national summary record. The aim is to move records to be as
‘paper light’ as possible. Integral to this aim is to have a high level of data quality
and integrity, with robust mechanisms in place to ensure the highest level of
accuracy and timeliness.
3.2.1 The provider arm must also to able to demonstrate effectiveness and efficiency to
win contracts in the new era of contestability. For this it will need to use technology
to improve value for money and improve standards (for example on waiting times).
The technology should also underpin pathway redesign internal to the provider and
as part of a wider pathway from referral to treatment for patients.
3.2.2 Access to information will be key when evidencing performance and achieving
targets; determining areas of service improvement and monitoring access to
services by patients and the public.
3.3 DELIVERING OUR ROLE AS COMMISSIONER
The key objective as a commissioner is to ensure all providers of services with whom
the PCT places contracts use appropriate national applications and deliver their
contribution to the national summary record, with high standards of data integrity
and quality. The specific requirements vary with the sector. For example, General
Practices have the IM&T directly enhanced service (DES) to ensure delivery of the
right data standards to upload to the national summary record. GP’s will be
encouraged to use the Choose and Book systems. Community Pharmacy is engaged
with the electronic transmission of prescription project. Providers of secondary
care (whether NHS or independent sector) must deliver the agenda with regard to
an electronic patient record, with a plan to use the local service provider (LSP)
offerings over time.
3.3.1 Each provider of services should be able to exploit the technology to demonstrate
value for money and improvement of patient care through standards and efficient
transmission of care via agreed pathways.
3.3.2 The full range of provider and commissioner responsibilities is outlined in “The NHS
in England: the operating framework for 2007/8, Guidance on preparation of local
3.4 VALUE FOR MONEY
As a public body, North Staffordshire PCT must deliver value for money and efficient
use of its resources. Managers need access to timely accurate information regarding
activity, finance and workforce and the PCT’s corporate systems must deliver this
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access. This strategy addresses the status and current plans for improving these
systems, including access to relevant information for Practice Based Commissioners.
The Fitness for Purpose development plan also refers to better and more systematic
use of evidence in decision making. The systems of access to such evidence will be
improved to ensure managers can deliver this target.
3.5 TAKING ADVANTAGE OF TECHNOLOGY
North Staffordshire PCT must keep up to date with emerging technology to ensure
that it can take advantage of technical developments. The use of e-business tools
will be examined. IT services are outsourced to the North Staffordshire IT and Health
Intelligence Services and North Staffordshire PCT looks to it to advise and support
the PCT on use of new technologies, in particular those which will support staff in
mobile access to records.
3.6 DEVELOPING OUR STAFF
An essential part of the local strategy must be to ensure all staff and professionals
associated with the PCT are fully trained and confident to use the systems which are
in use. This will include not just technical skills, but an understanding and
commitment to data quality, data protection and Information Governance
3.7 REALISING THE BENEFITS
Technology is implemented to improve services. It is essential that each system and
project implemented is followed up with an ongoing benefits realisation plan. Often
the benefits are not seen until a number of months after the end of implementation.
The PCT will ensure that active monitoring of benefits is undertaken to ensure that
all planned benefits are delivered.
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4.0 THE NATIONAL STRATEGY
4.0.1 The NHS has developed a comprehensive Information and Technology strategy to
support the key policies starting with The NHS Plan and subsequent updates. It is
known as the National Programme for IT (NPFIT).
4.0.2 As defined by Connecting for Health it is the aim of NPfIT to “improve patient choice
and the quality and convenience of care by ensuring that those who give and receive
care have the right information at the right time”.
4.1 NATIONAL PROGRAMME FOR IT (NPFIT)
4.1.1 NPfIT was established in 2002 to implement the national IM&T strategy “Delivering
21st Century IT Support in the NHS”. It aims to bring modern computer systems and
an integrated IT infrastructure to improve patient care and services and to transform
the way the NHS works by enabling shared access to patient information at the point
of care. In time, it will be used by over half a million clinical and support staff in the
NHS in England. It will give patients direct electronic access to their personal health
and care information.
4.1.2 The key NPfIT components are:
National Care Records Service (NCRS) – the electronic patient records
connected to a national data spine
Choose and Book (C&B) – the system to enable electronic referral and
appointment booking from primary to secondary care
Electronic Prescription Service (EPS) – the system which enables electronic
transmission of prescriptions from GP surgery to local dispensing pharmacies
Picture Archiving and Communications Systems (PACS) – the system for
holding and transmitting X-rays and other clinical images (including video)
GP Practice Systems
N3 – the national NHS broadband communications network
NHSmail – the national e-mail and directory service
My healthspace - a secure on-line personal healthcare organiser
4.1.3 Local Service Providers (LSPs) are consortia of system suppliers, contracted to deliver
IT systems and services at a local level for the five regional clusters of strategic
health authorities. Our PCT is within the Northwest, Midlands and Eastern (NME)
Cluster which has CSC Alliance as the LSP.
4.1.4 NPfIT is an ambitious programme which has experienced delays, with current system
migrations running 2 years late and there are concerns over its achievability.
Following the National Audit Office report in 2006, there have been positive changes
in the structure and product development although the achievability of published
timescales is still subject to debate.
4.2 OPERATING FRAMEWORK FOR 2007/8
4.2.1 The Operating Framework for 2007/8 includes a significant requirement for the
second phase of NPfIT developments. It describes a strategy which includes
“…sustained focus on information management and technology to underpin the
reforms and deliver better, safer care”. It specifically states that “IM&T is central to
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the delivery of health reform, supporting patients in their choices and helping to
deliver better, safer care. That is why we remain committed to the vision of a modern
IT-enabled NHS set out in “Delivering 21st Century IT Support for the NHS” and to a
national programme for IT
4.2.2 All PCTs are required to have local IM&T plans “to actively build the IM&T and
service transformation capacity and capability required to deliver this modern, IT-
enabled NHS” with the goal for 2011 is that NHS IM&T “will enable safe and
seamless delivery of patient care across organisational boundaries”.
4.2.3 Strategic Health Authorities are now accountable for NPfIT implementation and
benefits realisation with ownership residing with the NPfIT Local Ownership
Programme (NLOP). Connecting for Health continues to be responsible for
managing national contracts and developing national standards and tools and
services to support local implementation.
4.2.4 There is a clear expectation that all English PCTs will migrate to or link to NPfIT
products and services. In preparation, providers are required to ensure they have
clear policies and processes in relation to data sharing and data handling,
implementing the Care Records Guarantee (which ensures patient’s rights to
confidentiality), disaster recovery plans and fully utilising the NHS Number.
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5.0 NORTH STAFFORDSHIRE HEALTH COMMUNITY STRATEGY
5.0.1 To fully realise the benefits of NPfIT North Staffordshire PCT is be a part of the move
for all NHS organisations in North Staffordshire to join together to deliver NPfIT and
associated national directives e.g. GPSoC. There will be a unified plan to deliver the
various programmes and projects although each organisation will remain
responsible for delivering the actual implementation of the projects. This initiative
includes both the North Staffordshire IT and Health Intelligence Services to ensure
standards and commonality of direction.
5.0.2 The benefits of this approach can be seen from the joint implementation of the CRS
system project managed by the North Staffordshire Health Intelligence Service, with
input from clinicians, managers and admin staff across the North Staffordshire Local
5.0.3 There is a joint governance structure across North Staffordshire which is currently
awaiting ratification by the Chief Executive Partnership Board.
5.1 PROPOSED STRUCTURE
5.1.1 For the structure (see Figure 1.0) to work there must be active participation
and support form the Senior Responsible Officer (SRO), for North
Staffordshire this is Tony Bruce, and senior staff within the Health
organisations without which, the IT plan will not be implemented or benefits
achieved due to lack of commitment and buy-in by NHS staff resources.
5.1.2 The main CfH Projects: CAB, CRS and UHNS EPR, should report directly to the
LHE strategy Board, through their individual project boards, to present,
discuss and resolve issues via the medium of PRINCE2 highlight reports. The
LHE strategy Board should ensure that progress is monitored against
proposed implementation plans any issues preventing or delaying
implementation should be discussed, resolutions agreed and decisions
cascaded back to project boards/steering groups, via the project managers,
for implementation. Any issues that cannot be resolved locally e.g. within the
LHE strategy Board or the CEO Partnership Board, should be escalated via the
governance structure. The main projects should also maintain links directly
with the SHA for guidance and assistance on a day-to-day basis.
5.1.3 The LHE Strategy Board should also set IT Strategy and direction e.g. creating
and delivering the LHE IT Plan as per the NHS Operating Framework
5.1.4 All other IT related projects are reported through the IM&T Sub-groups via
the monthly Programme Report published by the Health Intelligence Service.
Operationally, this group should monitor the implementation of the LHE IT
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Figure 1.0 – Governance Structure
SHA delivery Board
CEO Partnership Board Committee
LHE Strategy Board
PCT IM&T Sub-
HIS Customer Board
Choose and Book National Care record Other CfH Projects
FFtF and PACS CBSA UHNS EPR
(CAB) Service (CRS) EPS All non-CfH Projects
Project Board Project Board
Project Board CAB Steering Group Project Board Project Board
Clinical and Project
Senior Project team Project Teams
Advisory Board Project Teams Project Teams
PCT Project UHNS Project CHT Project HIS Project
Teams Team Team Manager
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6.0 CONNECTING FOR HEALTH
6.0.1 The CfH programme is central to the local IM&T strategy. North Staffordshire PCT
purchases services from the North Staffordshire IT and Health Intelligence Services
which acts as the key planner for the NPfIT strategy in the North Staffordshire area.
Progress towards the national programme is monitored by the North Staffordshire
LHE Strategy Board who review whole system progress towards meeting the
national strategy. Many programmes are managed through the HIS although local
contributions within the PCT are closely monitored via the IM&T sub committee
which reports to the PCT Executive Board. As such project plans and progress are
monitored closely. Once a project is complete, the committee will expect follow up
benefits realisation reports to ensure that the technology is supporting patient care
6.0.2 As commissioner the PCT will ensure that providers with whom it contracts adhere
to the IM&T requirements set out in the NHS Operating Framework 2007/8 and its
successor publications. This will include the IT shared agencies.
6.1 NCRS - LORENZO
6.1.1 The Lorenzo system is in development with the first release of the redesigned
system scheduled for December 2008 by CSCA. Version LE 2.2 is currently being
implemented in community services within North Staffordshire and is already in use
within a number of services. CSCA have issued a ‘road map’ identifying how the
system will increase the functions it offers until it is considered a full care record
service. The functions available now largely support patient administration including
patient registrations, referral management, caseload allocation, appointment
booking and waiting list management. The next release of the system, due in 2008
will start to include some clinical functions to support care pathways and by 2009
the system will support a full electronic patient record. If the national programme
delivers Lorenzo 4.0 as planned, then the PCT will aim to have most clinical services
using the system for full electronic record keeping by 2010. This will mean that
paper records will be limited and referrals and discharges will be made
6.1.2 It is proposed the implementation of the Lorenzo system will follow the Penfield
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6.1.3 The functionality is summarised below:
Summary Function Release 1 Release 2 Release 3 Release 4
Single Sign ON
Patient Requests & Results
Identity Services including PDS
Choose & Book
Mental Health Administration &
PSIS View & Initial PoC
Advanced Bed Management
Consent for Treatment
Enhanced PSIS functionality
Mobile computing and
Integrated Care Pathways
Cross Instance Interoperability
Note that the colours of the ticks in the above table are matched to the colours
used to depict the releases in the Penfield Release Strategy above.
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6.1.4 Work is underway to look at how services provided and commissioned by the PCT
will use Lorenzo to support patient care based on a whole systems approach, to
ensure that there is consistency in use and benefits of the system are realised as
early as possible.
6.1.5 The implementation has been planned using Managing Successful Programme (MSP)
and PRINCE2 methods. This incorporates not just practical implementation but a full
benefits realisation and business change programme.
6.2 CHILD HEALTH SYSTEM
6.2.1 The current Child System provided on the CHIPS (Combined Healthcare Information
Processing System), system adequately provides the required functionality to
support the Child Health and Child Protection local and national requirements.
6.2.2 It is a requirement of NPfIT that child health system should integrate with other
national systems e.g. CRS. The existing Child Health system in use by the PCT will not
be able to fulfil this requirement therefore, a new system will need to be
implemented. There are two systems available to North Staffordshire to fulfil this:
1. Health System Wales (HSW)
2. The Phoenix Partnership
6.2.3 There is no clear guidance on which of the systems is the preferred option in relation
to local and Health Authority-wide strategies. The current CHIPS system provides the
required level of functionality to meet national requirements therefore it is
recommended that Child Health remains on CHIPS under further clarity is received
from the health Authority.
6.3 PICTURE ARCHIVING AND COMMUNICATIONS SYSTEM (PACS)
6.3.1 A key deliverable within the national programme, PACS captures, stores, distributes
and displays static or moving digital images such as x-rays or scans, for more
efficient diagnosis and treatment. PACS effectively takes away any need to print on
6.3.2 The implementation of PACS enables images to be sent and viewed across several
NHS locations resulting in increased capacity of diagnostic services. Digital images
will form an essential part of the patient NHS care record.
6.3.3 Locally in North Staffordshire, PACS is being implemented as part of University
Hospital of North Staffordshire’s (UHNS) PFI project and not as part of NPfIT. This
was a decision made internally within UNHS and has had an small impact on the PCT
in that the PCT has become responsible for the purchase of the diagnostic and
viewing PC’s required within the community hospitals to access the PACS system. To
fully realise the benefits of the investment in both PACS and new PC’s the
technology should be supported by wireless network infrastructure on the wards to
allow images to be viewed at the patient’s bedside.
6.3.4 Further implementation of PACS in services such as Community and General
Dentistry, Community Services and General Practice will be assessed in line with
service development over the next 2-3 years.
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6.3.5 Integration of the PACS System in operation as part of the Independent Sector
Diagnostics Centre (ISDC) contract with ATOS Origin across the Strategic Health
Authority will be addressed during the course of this strategy.
6.3.6 By 2010, all relevant picture images whatever the provider’s origin, should be
available to the professionals requiring them in their clinical setting.
6.4 CHOOSE AND BOOK
6.4.1 The PCT has worked with GP practices within North Staffordshire to ensure they all
have access to the Choose and Book system. Currently the system is available only
to GPs and for new outpatient referrals. Diagnostics will shortly be added, and the
PCT will ensure the Provider Services diagnostic services are added to the system.
The local vision is to ensure that all services which GPs wish to refer to are available
on choose and book with a directly bookable option. This should include local acute
Trusts, diagnostic and community services. Practitioners other than GPs should also
be able to use the system, so for example a practice nurse should be able to book a
patient into a community diabetic clinic using this technology. The technology will
be used to ensure that the PCT’s strategic commissioning objectives are met, that is
to give patients choice, book their appointment as close to referral as possible and
ensure their total wait from referral to treatment is no longer than 18 weeks.
6.4.2 At present, GP’s in both North Staffordshire and Stoke-on-Trent PCT’s are only able
to utilise the Indirectly Bookable Service (IBS) functionality and will be unable to use
Directly Bookable Services (DBS) until the issues surrounding the implementation of
UHNS’s Electronic Patient Records (EPR) IT system have been resolved. Currently
timeframes indicate that this will happen in early 2008.
6.5 ELECTRONIC TRANSFER OF PRESCRIPTIONS
6.5.1 This project aims to ensure that all prescriptions generated by GPs will be
transferred electronically between prescriber, dispenser and the reimbursement
6.5.2 Significant progress has been made with Release 1 of the project, with the PCT
engaging successfully with all Community Pharmacists and a high number of GP
practices utilising also. Release 2 of the national project will be available in April
2008 and will bring further benefits. Release 2 will require a large resource
implication during the implementation phase however the full impact will be known
once information and lessons learnt are available form the early adopter sites
implemented during 2007.
6.5.3 A proactive Project Implementation Board has been formed across the North
Staffordshire Local Health Community involving representatives from IM&T,
Community Pharmacists, General Practitioners and Service Managers. The
Implementation Board will continue to monitor progress and facilitate
implementation of the project in scheduled stages.
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6.5.4 The benefits of ETP are to reduce risk of errors of transcribing from paper
prescription to pharmacy systems and to enable pharmacies to know what
prescriptions are in demand before the patient arrives so that the patient does not
have to wait. There are also time savings for GPs and pharmacists to give them
more time to focus on patients needs.
6.6 CLINICAL RECORD SUMMARY
6.6.1 The Clinical Record Summary is part of the NHS Care Records Service. Initially it will
contain a small data set of current medications, allergies and adverse reactions
which will be uploaded from GP systems. Over time it is anticipated that the
content will increase subject, to patient consent, to include a more complete data
set from GPs and also information from other providers of care including the
6.6.2 The clinical record summary will be available throughout England to those who need
to access it to deliver care and who have the necessary security permissions.
Consequently, it has the potential to bring major benefits to both clinicians and
patients especially when care is being delivered in settings where the patient’s
records are not usually available i.e. A&E, Ambulances and Walk-in Centres. The
clinical record summary will be implemented geographically with a public
information campaign carried out to support its implementation, supported by the
nationally developed Care Record Guarantee, which will aim to address any
concerns that members of the public may have.
6.6.3 It is the PCT’s responsibility to publicise and support the dissemination of the Care
Record Guarantee within its geographical area.
6.6.4 Information quality is key to the success and clinical safety of the Summary Record
and therefore a strict accreditation process is in place governing the uplift of any
data from GP systems to the Summary Record.
6.6.5 The accreditation of information held on GP systems forms part of the Directed
Enhanced Service (DES) for IM&T. The DES provides a framework and funding
arrangements for practices to improve their data quality to accredited levels, ready
for uplift to the Summary Record and also for further engagement in the NHS IT
Programme i.e. Electronic Prescription Service, Choose and Book, hosted solutions.
6.6.6 94% of practices have signed up for participation in the DES. Data Quality
Facilitators from the North Staffordshire Health Intelligence Service have been
supporting practices in the development and improvement processes required to
achieve accreditation (Component 1).
6.6.7 Accreditation of information will take place over 2007/8 utilising methodology and
tools provided by PRIMIS+ (Component 2). Following accreditation information will
be deemed ready for uploading to the Summary Record.
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6.7 PRISON HEALTH
6.7.1 There is a national requirement that prisons have IT clinical systems
implemented that will support improved healthcare within the prisons. There
is work currently underway within the PCT to ensure that this initiative is
implemented and that available national funding is used to ensure full
benefits are gained.
6.8 SECONDARY USES SERVICE
6.8.1 SUS is a system designed to provide timely, pseudonymised, patient-based data and
information for management and clinical purposes other than direct patient care.
The data is made available through the NHS Care Records Service. These 'secondary
uses' will include functions such as healthcare planning, commissioning, public
health, clinical audit, benchmarking, performance improvement, research and
6.8.2 SUS is a single, secure data environment for the whole NHS. Coupled with effective
analysis tools, it enables a wide range of users to carry out comprehensive analysis
of data in a consistent and effective way.
6.8.3 Information is pseudonymised (protecting patient confidentiality by allocating it a
consistent 'pseudonym') and access is governed through rigorous data access
controls to protect patient confidentiality.
6.8.4 The vision for the Secondary Uses Service is to capture, process and enable access
and reporting on all data relating to NHS-commissioned activity. The full vision
statement is available on the web:
6.8.5 The impact of SUS as it applies to the local strategy over the next three years will
apply to the commissioner role initially. This is because the contract data sets
collected by hospitals is now made available to PCTs using this tool. There is an
added value tool supporting payment by results in the first phase of SUS. As the
vision indicates above, this is seen very much as stage one. Overtime, it is
anticipated that all data sets collected by the NHS will flow through SUS and when
possible data reports (e.g. waiting lists) will be generated from the source data
rather than required from NHS Trusts with the plan this will make performance
monitoring more efficient. As a commissioner, we place and monitor contracts with
providers, but over time we will also need to enforce the data quality standards to
ensure that all data which flows to national systems meets the quality criteria laid
out, whether the source be primary, community or private sector providers. In
addition to data quality, the timeliness of data capture is key to ensuring the PCT has
accurate data ready for nationally mandated data submission flex and freeze dates.
Payment by Results information is calculated from ‘frozen’ data. Poor data can
result in loss of income for the PCT as a whole.
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6.9 REGISTRATION AUTHORITY
6.9.1 Access to national programme applications such as the national spine and Choose
and Book requires NHS staff to possess a card and pin with a robust registration
process governing access rights and authentication of individuals.
6.9.2 The PCT has made considerable progress and has ensured that all staff that require
access to applications have a card and have been through the registration process.
A dedicated team has been established to implement the programme working
alongside colleagues involved in the implementation of the NCRS Community
System, Choose and Book and Electronic Transfer of Prescriptions. Capacity will
continue to be monitored to ensure sufficient resource to meet demand.
6.9.3 As a matter of policy, all PCT staff requiring access to national programme clinical
systems will be issued with an NHS smart card. Initially this card will be used solely
for access to the national clinical applications, but wider use of the card for other
local and national applications will be evaluated.
6.10.1 The Portal has proven to be an invaluable tool in supporting PCT staff to access
information and applications such as MS Outlook (email and calendar) and supports
working from home. At present NHS staff are unable to access any resources held
on the network drives and directories however, this can be accessed by the purchase
of a ‘token’ which provides secure access to the network.
6.10.2 The portal is also an excellent tool for providing information to the public and
patients and directly supports the national Access to Information and Freedom of
Information initiatives; and for sharing information across teams. New technology,
as it becomes available, will be investigated in support of providing useful and
efficient document management and information sharing tools. This technology is
shared across the PCT’s and Combined Healthcare so a joint way forward will be
developed in partnership through the LHE strategy Board.
6.11 NHS MAIL
6.11.1 NHS mail is a national system which is fully encrypted. This enables safe transmission
of patient data by email. The North Staffordshire IT Service will lead a review of how
to use this potential locally to give business gain. There is currently ad-hoc take up
of the service on a need-to-use basis, but the IT review will consider if it should be
the default for all mail services. At present NHSmail is used alongside local email
systems wherever the direct need arises. There are no plans at present to move
from the local mail service based on the issues regarding the extra traffic congestion
on the network, limited functionality, and a generally poor uptake nationally.
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7.0 PCT PROVIDER SERVICES SYSTEMS
7.0.1 The PCT is committed to using all of the national applications as they are available
and relevant. Currently, the main systems in use by the Provider Services are CHIPS
and NCRS. Ultimately, all services will be migrated from CHIPS to NCRS with CHIPS
being decommissioned as a clinical system.
7.0.2 Work needs to be undertaken to identify any other IT clinical systems in use within
the organisation to ensure they are a) migrated to NPfIT and then decommissioned
or b) monitored so that the required functionality, if not supported by NPfIT,
continues to meet the requirements of the service.
7.0.3 Some services may not yet be using an electronic system and would therefore need
to be assessed for inclusion in NPfIT or for the purchase of a suitable system.
7.0.4 Process for establishing the need for other clinical systems.
If a service requires a new clinical system or significant changes to an existing one, it
must submit a business case. The first choice for system requirements for new
systems will be those offered nationally as part of the NPFIT programme. If these
are not suitable, a review will take place for alternatives. Factors which will be
considered are cost, benefits to services and compliance with the national
programme for IT. The “legacy” systems will be reviewed annually by the PCT IM&T
Strategy Group and a development plan for each system undertaken to assess how
they will fit into the national programme in the medium term.
7.1 PERFORMANCE AND MARKETING INFORMATION
7.1.1 All businesses and organisations, including NHS Trusts, require a range of
management information in order to:
understand their environment
benchmark themselves against similar organisations
monitor and manage their performance against minimum standards, contracted
activity levels and improvement targets
identify trends and confirm projections against plans and targets
inform their decision making processes and future plans
7.1.2 The challenge is to ensure that information available is relevant, accurate, timely
and sufficient (but not excessive) to facilitate decision making and planning and to
communicate with partners effectively.
7.1.3 In recent years, the emphasis on performance management has increased
throughout the PCT with regular performance reports now being required and
management action taken to address performance and data quality issues.
7.2 CURRENT REPORTING
7.2.1 Currently the PCT uses a combination of CHIPS and CRS as its main data sources for
patient performance and contract activity reporting. Information is downloaded
into a customised data warehouse, used to run a range of reports. Some report
generation is automated and this is due to be further extended as further routine
reports are identified. ‘Cubes’ are developed and updated on the PCT’s intranet to
provide management information to PCT managers.
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7.2.2 Over the last three years, the reports required have changed from being
predominantly activity “numbers” to a greater proportion of targeted information
and indicators linked to specific national and local targets with most being reported
monthly rather than quarterly.
7.3 DRIVERS FOR CHANGE
7.3.1 The strategic drivers, particularly the introduction of Practice Based Commissioning
and Payment by Results, significantly increase both the importance and complexity
of performance, contracting and marketing information.
7.3.2 The guiding principles to be adopted in the next stage of performance tools are:
an integrated approach to the use of information
producing easy to understand reports with sufficient but not excessive levels of
detail for the intended audience
using automated tools to generate reports
developing clear procedures and definitions for recording and reporting
standardising codes used in recording to facilitate reporting
developing sets of baseline reports which can be customised and extended
auditing reports to verify and validate results
greater availability / interactive reports with access to drill down facilities
ensuring that management information and reports can easily be published and
distributed to managers and lead clinicians
developing and implementing systems which enable managers and lead
clinicians to access and interrogate the data in a format customised to their own
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8.0 PRIMARY CARE CONTRACTOR SYSTEMS
8.1 GENERAL PRACTICE SYSTEMS
8.1.1 The PCT presently (as of October 2007) has 35 GP practices (see appendix 1) utilising
four different computer systems and three different suppliers. The vast majority
use EMIS systems (80%) with 21 practices using the EMIS LV system and seven the
EMIS PCS system. Five practices use the INPS Vision 3 system and six Microtest
8.1.2 Connecting for Health recently issued a proposal for a scheme to facilitate the
continued modernisation of GP systems whilst offering GP Practices a choice of
systems, known as GP Systems of Choice (GPSoC).
8.1.3 Under the scheme funding for system upgrades will be made available to PCTs but
may only be utilised for those systems that have reached a level of compliance with
GPSoC standards. There will be six levels of compliance with GPSoC standards.
8.1.4 The national policy is that practices will stay with their existing supplier and will
upgrade their system as the supplier achieves compliance with various levels, with
the PCT funding the upgrade through payment of annual service charges via an
allocation from Connecting from Health. Practices will not be eligible for funding if
they choose to change systems unless it is with the offering provided by the Local
Service Provider (CSCA for the North West and Midlands Cluster) or they wish to
move to another supplier who has achieved Level 4 compliance.
8.1.5 Within North Staffordshire PCT all practices currently have a system that would
achieve Level 2 compliance with GPSoC. EMIS LV practices will be able to achieve
Level 3 and PCS Level 2. InPS practices will be able to achieve Level 3 and Microtest,
Level 2. All system suppliers aim to progress through the standards and achieve
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8.1.6 The current view of the StHA and CSCA is that to achieve Level 6 the Systm1 GP
system supplied by The Phoenix Partnership (TPP) should be implemented.
However, Systm1 is only accredited to Level 2 at present with a development
pathway to Level 4 by June 2008 therefore, careful considerations will be made
before any plans to move to this system are implemented.
8.1.7 The PCT will develop plans to develop GP systems to meet Level 4 requirement using
the current systems that GP’s are using. Any GP who wishes to change to a new
system can only move to another system that has been accredited for Level 4. There
is a national requirement to have GPSoC development plans in place by November
2007 outlining how this is to be achieved. PCT plans will tie in to the GP system
Supplier roadmap for development and achievement of GPSoC levels indicating that
Level 4 can be achieved by December 2008 assuming GP’s sign up to the other
requirements of GPSoC.
8.1.8 It is expected that all practices will migrate to the CSCA solution once it has achieved
Level 6 compliance and has been certified by GP professional representatives as
offering improved functionality compared to other systems. The extent of the
migration in 2010 depends on a number of factors and cannot be predicted at the
time of writing this strategy.
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9.0 PCT CORPORATE SYSTEMS
9.1 ELECTRONIC STAFF RECORD (ESR)
9.1.1 The PCT has implemented the national Electronic Staff Record System (ESR) which
provides a basic personnel record linked to Payroll. During 2007/8, modules for
local recording of attendance, recruiting, learning management and talent
management will be implemented. These require a significant change in working
practices in many teams, supported by training and development.
9.1.2 Training records will be transferred from existing storage media to the learning
module of ESR.
9.1.3 It is essential that ESR and its implementation within the PCT can effectively meet
the employment information recording and analysis requirements of equality
legislation and the PCT’s equality scheme.
9.1.4 A review will be undertaken to consider the use of staffing information within the
PCT and to identify opportunities to further develop and cross reference data
between systems such as ESR, rostering, telephone directory etc for both
operational and reporting purposes. Standardising codes and data structures will be
beneficial for future developments.
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10.0 INFORMATION GOVERNANCE
10.0.1 Information Governance addresses the demands that law, ethics and policy place
upon information processing. The PCT is tasked with ensuring that there is constant
review and to improve how it holds, obtains, records, uses and shares information.
10.1 INFORMATION GOVERNANCE TOOLKIT
10.1.1 To aid NHS Organisations in the development and management of Information
Governance the Department of Health provide a supporting framework in the form
of a toolkit. The toolkit addresses all areas of Information Governance:
Freedom of Information
Confidentiality Code of Practice
Information Quality Assurance
Information Governance Management
Health Records Management
National Programme for IT
10.1.2 The PCT is able to self assess its performance through compliance with standards
with individual criteria in all areas of Information Governance. These scores are
submitted to the DoH in March annually.
10.1.3 A key criticism of the toolkit has been its focus on Acute NHS Trust settings and the
lack of applicability to PCTs. This was addressed in the recent revision to the toolkit
in September 2006. Criteria for General Practice were added in December 2006.
10.1.4 Over the life of this strategy the PCT will work to ensure it achieves full compliance
with all areas of the toolkit. As a commissioning body the PCT will also work with
local contractors to ensure that Information Governance standards are high and
robust plans in place for improvement where required.
10.1.5 A key area for further development during 2007 will be improvements to
information sharing protocols and processes, particularly in joint work with the City
Council and other non-health bodies. The PCT has signed up with other Trusts and
Agencies to an Information Sharing Policy. Further work is required on ensuring the
policy is implemented effectively throughout all organisations and actively utilised
for all areas of information sharing.
10.2 DOCUMENT AND RECORDS MANAGEMENT
10.2.1 The PCT has identified that improvements to the management of both health and
corporate records are essential. The PCT has significant challenges and issues in this
area. Many of the current issues can be attributed to the disparate nature of the
organisation which is provided over numerous sites and also to the many
reorganisations the organisation has faced in the past six years.
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10.2.2 There are many historical records stored in health centres and other sites across the
PCT generating risk and cost implications. To overcome this, the PCT will re-evaluate
its investment in the e-DMS project at Bucknall Hospital to ensure that value for
money and return on investment is achieved.
10.3 MEETING DATA QUALITY STANDARDS
10.3.1 For provider
The importance of accurate recording of data at source cannot be overstated. The
PCT is committed to ensuring that systems are used to the greatest benefit for
patients and professionals and this means having all data stored electronically
accurately recorded and coded where possible. There are various external drivers
also such as the Information governance toolkit and the Audit Commission’s
Auditors Local Evaluation Assessment (ALE review).
10.3.2 The PCT will review its data quality policy annually and deliver regular monitoring
reports as part of the Provider reporting cycle. Training on the importance of data
quality will be given as part of the induction and is also covered in mandatory
Information Governance training sessions.
10.3.3 As the clinical systems in use within the PCT develop to include clinical information,
the PCT will create a clinical coding policy, training programme and audit
programme to support this. SNOMED coding is implemented as part of the
migration and implementation of the CRS system therefore data quality audit and
improvement plans will be developed.
10.3.4 As commissioner
10.3.5 For Acute and Mental Health Trusts
The PCT will ensure that providers with whom it contracts have appropriate
standards for data quality and clinical coding. The PCT will have regular dialogue
regarding data and coding issues with its significant providers. The PCT maintains an
SLA with UHNS for the coding of their data and this will be supported through
regular internal and external audits.
10.3.6 For Primary Care Contractors
The PCT has a history of working with General Practice to improve data quality and
utilise information for quality and planning purposes through the Data Quality
Facilitators. Work plans are agreed by the PCT and priorities set in partnership with
10.3.7 Whilst a key focus for practices has been on the Quality and Outcomes Framework
indicators, the PCT has also ensured that other priority areas including National
Service Frameworks are addressed and a robust Information Quality Programme is
10.3.8 A key focus for the Data Quality facilitators will be to support practices in the
implementation of the Directed Enhanced Service (DES) for IM&T as part of the GMS
Contract a key aspect of which will be the assurance of the quality of information
that is uplifted to the NHS Spine with a formal accreditation process in place.
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10.4 CBSA – COMMISSIONING BUSINESS SUPPORT AGENCY
10.4.1 The CBSA objectives are to provide:
Existing commissioning support activities more economically and effectively
An extensive and high-quality data management system to support
A mechanism for PCTs to meet their national and local reporting and analytics
To broker the relationship between PCT and providers to support commissioners
in managing contracts and the performance of providers
Innovative analyses of activities to help commissioners develop approaches to
changes in health economy
Provide procurement expertise to commissioners to support them in obtaining
value for money and improved patient care
10.4.2 In October 2007 the CBSA issued a draft Core Service Description outlining the
support that would be provided in the following functional areas:
Practice Based Commissioning
10.4.3 The PCT will ensure that it receives return on its investment by utilising the CBSA for
its commissioning information and business support.
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11.0 JOINT WORKING WITH THE COUNTY COUNCIL
11.1 There are a number of policy areas where delivery of effective care to patients
requires joined up cohesive working between professionals in health and other
sectors such as education and social care within the county council. Nationally
there are separate strategies and programmes for the delivery of information
systems for health and for Social Care. Both the PCT and the County Council have
separate IM&T strategies and system implementation programmes.
11.2 It is vital however that there is ‘joined up thinking’ between the PCT and
County Council with shared understanding of strategy, effective
arrangements for information sharing, joint working and where appropriate
and feasible, integrated working. Progress has been made in this area during
2006/7 and this will be built on during the course of this strategy.
11.3 A number of key principles underpin this strategy and the approach taken by IM&T
to ensure a focus on the needs of the population are met.
Technology should be an enabler not a barrier.
The PCT and County Council have a duty to provide best value and work in a
joined up way.
An element of trust needs to exist between council and health IT staff with an
understanding that both work for publicly accountable organisations and both
will have strict and audited security policies and procedures. These policies and
procedures will be made available across the organisations.
The benefits of the above will be for patients or customers and the professionals
supporting those patients/customers.
11.5 A number of projects are in progress implementing national policy on the concept of
person centered care, providing assessment tools and information which is shared
and readily available across organisational and agency boundaries.
11.6 These include:
Single Assessment Process (SAP)
Common Assessment Framework (CAF)
ContactPoint (Information Sharing Index)
11.7 The PCT is actively engaged in the development and implementation of these
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12.1 FINANCIAL INVESTMENT
12.1.1 The PCT has made significant investment in the past 3 years to support the
modernisation of the infrastructure, investment in new technologies and provision
of the capacity and capability of support staff. A significant proportion of this
investment has been in the North Staffordshire IT and Health Intelligence Services
which provides a range of informatics services delivered through an SLA and
governance structure. This has laid a firm foundation for the implementation of the
National Programme for IT and service improvement.
12.2 NORTH STAFFORDSHIRE IT AND HEALTH INTELLIGENCE SERVICES
12.2.1 During 2007 the PCT will renegotiate the SLA with the shared IT agencies to better
understand the service provision and guarantee value for money and return on
12.2.2 The IT shared agencies are expected to produce significant benefits to the local
community in the provision of IT support and implementation of the National
Programme, maximising the effective and efficient use of available resources and
improving the provision of service to NHS partners.
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13.0 FUTURE WORK PLANS
13.1 Work programmes will be undertaken in a number of areas:
13.2 Internal and external reporting requirements will be reviewed for both national and
local performance and contracts monitoring, and work programmes will be
developed to ensure the data warehouse, reporting tools and support service can
provide timely and accurate information reports which are clear, concise and easy to
use. The types of information used to generate reports are likely to increase, with
greater use of clinical indicators. The challenge will be to develop indicators which
are genuinely useful but not onerous to produce.
13.3 Developing indicator systems which quickly highlight current and potential problems
(“alerts”) to the user either through a dashboard or more formal identification will
13.4 The new financial and governance arrangements within the NHS require changes to
reporting arrangements. The requirements will be reviewed and action plans
developed to ensure CHIPS and other systems are capable of holding all data
required for Standards for Better Health, PbR, PbC, national performance indicators
etc and that performance can be reported easily.
13.5 The increased use of information proposed, requires it to be timely, accurate,
validated and attributable. A data quality policy has been developed and will be
implemented to set and improve standards for data recording in terms of both
accuracy and timeliness.
13.6 Many of the governance arrangements, such as Standards for Better Health and
Information Governance, require the PCT to give assurance of compliance. The
evidence required is often used in more than one standard or area and therefore the
effective management of this process requires evidence libraries to be collated
which can be cross referenced. A project will be undertaken to collate soft
13.7 There will be an increased requirement for development and reporting of clinical
indicators (such as incidents) and interpretation of clinical outcomes for clinical
governance in relation to Standards for Better Health, clinical audit etc. This will be
considered and used to inform other developments within this strategy.
13.8 Migration to electronic patient records will have a significant impact on current
reporting arrangements as the source data is likely to change, therefore new data
warehouse arrangements will be required. All planned performance and reporting
developments will be assessed to consider their ability to operate in both the
current and future patient system environment.
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14.1 The vision for the PCT in 2010 contains the following ambitions:
All booking will be electronic.
All access control to all systems will be via smart cards. There will be a single
sign on procedure.
Clinical record summary will be populated by GP systems and patients will be
able to see their own clinical summary record.
All prescriptions will be transmitted electronically. Pharmacies can check clinical
summary records when their access rights allow.
Hospital prescribing will be electronic.
Most GPs will be using a single system which will meet level 5 standards
(interoperability between GP systems and Lorenzo).
When a patient transfers between GPs, the patient’s electronic record will be
transferred electronically also.
NHSmail will be integrated with local mail systems to enable safe transfer of
patient based data by email. The system may even be used by patients.
Tools to support the GP Contract will be developed further and will keep up with
developments in the contract.
The Lorenzo system will be fully in use for clinical care records and will include
full integration of child health.
Records will be held safely and securely.
Staff will be fully confident in using data sharing protocols and will be aware of
their responsibilities regarding patient confidentiality and electronic media.
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Appendix 1: GP Systems and Suppliers
Practice Supplier System Version Address line 1
Bennett & Partners EMIS LV v5.2 Werrington Surgery
Biddulph doctors EMIS LV v5.2 Biddulph Medical Centre
Carpenter & Partners EMIS LV v5.2 Moorland Medical Centre
Craven & Partner EMIS LV v5.2 The Surgery
Deaville EMIS LV v5.2 Newcastle High Street Medical Practice
Franklin EMIS LV v5.2 132 Liverpool Road
Griffiths & Partners EMIS LV v5.2 Kingsbridge Medical Practice
Hindmarsh & Partner EMIS LV v5.2 Ashley Surgery
Holland & Partners EMIS LV v5.2 Kidsgrove Medical Centre
Hussain EMIS LV v5.2 Castletown Surgery
King EMIS LV v5.2 Biddulph Medical Centre
Manudhane VV EMIS LV v5.2 The Village Surgery
Morgans & Partners EMIS LV v5.2 Silverdale Health Centre
Oleshko & Partners EMIS LV v5.2 Moss Lane Surgery
Porcheret & Partners EMIS LV v5.2 John Kelso Practice
Rabie & Partners EMIS LV v5.2 Kidsgrove Medical Centre
Rees AF & Partners EMIS LV v5.2 Stockwell Surgery
Rupert Street Surgery EMIS LV v5.2 5 Rupert Street
Thorley & Partner EMIS LV v5.2 Higherland Surgery
Upton & Partners EMIS LV v5.2 The Tardis Surgery
Yates DO & Partners EMIS LV v5.2 Well Street Medical Centre
Brown M EMIS PCS Alton Primary Care Centre
Cooper EMIS PCS The Surgery
Gardner & Partners EMIS PCS The Surgery
Malgwa & Partner EMIS PCS R J Mitchell Medical Centre
O'Byrne & Partner EMIS PCS University Health Centre
Patel N EMIS PCS The Surgery
Pilpel & Partners EMIS PCS The New Surgery
Lyme Valley Practice InPS Vision 3 Lyme Valley Medical Centre
Page & Partners InPS Vision 3 Audley Health Centre
Scriven InPS Vision 3 Leek Health Centre
Shapley & Partners InPS Vision 3 Wolstanton Medical Centre
Walsh InPS Vision 3 The Surgery
Acquah Microtest Practice Manager Loomer Road Surgery
Unyolo Microtest Practice Manager The Clinic
Page 35 of 51 North Staffordshire PCT IM&T Strategy v0.01
Appendix 2: 2007 – 2008 Financial Summary
Information Services - 2007/08 - Version 1
IM&T Funding Requirements
ADS Percentages 41.02
2006/07 Budget Sources
HIS 2006/07 final recurring baseline £950,711
Inflation increase net 1%
Inflation increase 9507
HIS Final Baseline 2007/08 £960,218
PCT and CHT non HIS spend
NPfIT Implementation contribution £83,000
Proposed Allocations: 2007/08
Funding for IT Training Facility Recurring £16,408
Conversion of Paper Clinical Records to Electronic £47,173
Unallocated funds £19,419
To be invoiced on a quarterly basis by Finance - these are
based on 2006-07 prices and may change
COIN original recurring commitment £49,284
COIN recurring costs for additional sites up to Mar 07 £28,356
PCMIS Revenue Consequences £10,370
PCIS Revenue Consequences £4,994
Community Portal £7,840
Electronic Waste Directive £250
CITRIX (reduced from 06-07 - less licences) £1,205
Storage Area Network (SAN) £7,015
Anti-Virus, & Intrusion prevention (no cost until Sep 08) £0
XML recurring costs £1,440
Checklist licences £0
Fujitsu national helpdesk charges hit from April 2007 cost per call -
this is an estimate and is dependent on number of incidents
Sub Total £128,462
TOTAL RECURRING COSTS £1,171,680
PCT and CHT non HIS spend -
COIN non-recurring new sites from April 2007 £0
COIN recurring costs for new sites 2007-08 £0
IP GP Clinical Systems £20,563
Access to Information - E-works £5,000
Merge LANs at 28 GP sites £27,890
Replace Citrix terminals with PC's for NPfIT £60,000
TOTAL SECTION 3 COSTS £113,453
TOTAL COSTS £1,285,133
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Other Costs - not recharged by HIS - invoices will come from elsewhere
National Programme Costs PCT
NCRS not yet known £0
End User Training Environment (EUTE) £16,000
West Midlands Health Authority Costs
SHA CfH Team £59,000
Sub Total £188,000
THE FOLLOWING IS FOR INFORMATION
LHE Modernisation Fund (fLIS) Baseline PCT
UHNS EPR Implementation April/June 2006 inc. £118,958
UHNS IM&T Baseline recurring £55,377
North Staffs HIS recurring now baselined £454,502
Sub Total allocated funds = £628,837
Note – These are direct costs attributable to the work of the IM&T service however there is
further investment in posts throughout the PCT and ongoing programmes to upgrade
infrastructure and hardware.
Page 37 of 51 North Staffordshire PCT IM&T Strategy v0.01
Appendix 3: IT Systems
System System Description Purpose Benefits
CHIPS CHIPS is a system based on the Oracle RDBMS (originally The Community System allows staff that Data entry is via means of the ‘Diary Entry’
version 6, currently on version 10g) and with the user work in the community to enter details of form, which aims to capture all activity
interfaces and reports written using Oracle’s development their contacts with patients amongst other for a member of staff on a particular
tools (Forms versions 2.3, 3.0, 4.5, 6.0; SQL*Plus; Reports things. The system was written with day. It allows the user to:
etc.). The platform for the database and user interface has speed of entry and ease of use in mind
Enter the date in question once.
always been Unix, originally ICL’s DRS NX and currently and as such makes use of defaulting the
Enter their mileage for that day.
SCO UnixWare/SuSE Linux. The user interface for all most likely options into navigation fields
modules is currently character mode ‘green screens’, etc. The system is used by as many as 40 Enter Details of their non-clinical
written in Oracle Forms 4.5, and is provided via terminal different staff groups or services, the most activity.
emulation on PCs or thin client Windows Terminals. notable being District Nurses, Health Enter details of group sessions (certain
Visitors and the Therapists. staff groups only) such as duration and
There are four main groups of modules on the Chips number of clients seen. These details
system: the Community System and related modules; The are used for Korner stats etc.
Client Management System (CMS) and related modules – Enter and amend referral (or episode)
mostly Mental Health; the Inpatient System and Related details for a patient seen on that day.
modules; and the Core Schema modules that are used by Enter patient contact details for a
all other modules. referral such as location, duration and
treatments given etc.
Enter any ‘Care Groups’ that a patient
The first CHIPS Module released was the Community may belong to such as diabetes etc.
System in 1992, followed by the Mental Health System
(later known as the Client Management System – CMS) in
1993 and the Patient Management System – PMS Other screens and menu options are
(Inpatients) in 1994. Combined Healthcare developers available separately to:
wrote the Community and Mental Health Systems in-
house. The PMS and closely related modules were written
by developers at what is now the University Hospital of Enter and amend referral details.
North Staffordshire. Originally the North Staffordshire Enter and amend patient demographic
Health Authority employed both sets of developers and all details.
systems were conceived as being part of an integrated View previous patient contacts,
system for North Staffordshire. However the two Trusts searching either by patient or date.
split apart and so did the IT systems, but Combined View mileage data for a month.
Healthcare still used some of the software designed for the View and amend previous group session
Acute hospital. As a result of the original systems design details.
there are many core database reference tables that are Run reports.
used across all modules, including the Master Patient
Page 38 of 51 North Staffordshire PCT IM&T Strategy v0.01
Index, although not all systems interface with these tables There are also many system management
using the same code. screens available to maintain code tables,
run more reports.
There are also two third party systems that interface
directly with Chips: PracticeWorks R4 (formerly System
2000) Dental System which takes an MPI feed; and Training manuals are available for the
OptiImage records scanning system which also takes an Community system for the following
MPI feed. services:
Child Health Module The scheduling process will produce clinic
lists to be sent to the appropriate
clinic/surgery, appointment mailers to be
The Child Health system was developed to sent to parents and reports showing which
schedule appointments for, and keep children are in the queues to be
records of, Developmental Examinations seen/vaccinated/immunised.
(DE) and Vaccinations and Immunisations
(VI). The system is used primarily for these The system also has screens that relate to
purposes in relation to pre-school children data administration for child records such
by the Child Health Department at Bucknall as patient demographics, hearing test
Hospital, and the School Health Service at results, block changes of treatment centres
Bedford House also uses it for recording
details of VI and DE sessions with school
children, though they do not schedule
appointments. The system is also available
on a read only basis to Health Visitors
The Chiropody Appointments System Allows patients to specify what days or
times they can be seen, any other patients
Makes use of existing data in the they want to attend with, or the particular
Community System to provide an Chiropodist they wish to be treated by.
appointment history, determine where and Automates the booking of appointments
Page 39 of 51 North Staffordshire PCT IM&T Strategy v0.01
when a patient is to be seen, highlight for regular patients
patients suitable for Foot Care Assistant Reuses cancelled appointment slots and
treatment and arrange assessments for reschedules cancelled clinics.
new referrals. Prints diary sheets and appointment
Speech and Language Appointments This system allows the Speech and
Module Language Therapists to book appointments
for clinics and print letters inviting patients
to appointments etc.
Appointments are not scheduled. The
actual details of the appointments are
recorded in the Community System.
Health Visitors Family Profiles The Health Visitors had been manually
producing an annual caseload profile for
their individual caseloads, which took up to
In 1993 a system was released on CHIPS 3 man days to produce, and reported on
that allowed them to enter the information numerous facets of their caseload such as:
required for each family and child within No. of patients; No. of Families; No. of
that family required for the annual profile carers who smoke; No. of children hearing
report that wasn’t already entered via the tested; etc.
CHIPS Community System.
This system records details about a family,
The information in this system, Community
such as social class, language/cultural
System and the Child Health System are
differences etc., and details about each
collated to produce an annual Profile
child (or about the mother’s birth
report and a Performance Indicators report
experience with that child) in the family.
that gives percentage breakdowns of
The details about the child that are
recorded include whether they are
breastfed at certain times, whether the
main carer smoked etc.
The performance indicators report is
produced from a SQL Server OLAP database
cube after the relevant data has been
extracted off the three CHIPS systems.
Page 40 of 51 North Staffordshire PCT IM&T Strategy v0.01
School Health Module Records vaccination / immunisation and
developmental histories for school
The system maintains registers for each of delivered sessions
the schools and school nurses allocated to Records child’s special needs requirements
each school. It records which school each and other services input (ie speech and
child has attended and is attending. language, physiotherapists, etc)
Child Protection Module Allows supervision of the child’s monitoring
by recording the last reviewed date and the
The system allows children to be added to next review due date, who has had contact
the register, and the nature of the risk to with the child / family and why, and other
be recorded. End dates can be entered on staff activity on the child’s case.
the records and the social worker assigned
to the child’s case recorded.
Client Management Module The CMS Client Management system
provides functionality for the recording of
The CMS system comprises the following information relating to contacts between
sections; - Combined Healthcare staff and their
clients. These contacts relate
General Client Management predominantly to Mental Health care,
Appointment Management/Booking In though attendance at Leek Moorlands
Printed Outputs / Clinic Lists / Request Minor Injuries Department and Longton
Notes Cottage Hospital X-Ray department is also
Clinic Management (Outpatients) recorded within the CMS system but are
Groups / Individual Appointments covered by separate documents.
Clinical Psychology Department
Community LD Day Units
Mental Health Crisis Screen
Page 41 of 51 North Staffordshire PCT IM&T Strategy v0.01
Mental Health Act Module The system enables the recording of clients
detained under the act (Sections), the
The MHA system provides for central
renewal and removal of such detentions.
administration of the Mental Health Act for
Mental Health and Learning Disability
Care Programme Approach The system enables the recording of review
meetings and their outcomes, assessments
and generation of letters to all members of
The CPA Care Programme Approach the clinical team
systems provides for central administration
of CPA for Mental Health and Learning
Disability Directorates. The system records
the intention to place clients on CPA and
the actual CPA details decided on by the
clinical teams involved, the clinical teams
themselves and the eventual removal of
clients from the register.
Liaison Psychiatry Module The LPS system provides the Liaison
Psychiatry team with a means of recording
information relating to self-harm referrals
The system captures details of assessments to the Trust from the Accident and
and follow-up advice and arrangements. Emergency Unit.
Minor Injuries Module The system records details relating to time
waiting for treatment, investigation
undertaken, treatment and advice given
The Minor Injuries system provides for the and follow-up notifications are captured
recording of casualties seen at the Minor and printed notifications for health visitors
Injuries department of Leek Moorlands of young and elderly casualties are
X-Ray Module The system records details information for
clients attending the x-ray unit at Longton
Page 42 of 51 North Staffordshire PCT IM&T Strategy v0.01
The X-ray module enables the recording of
x-ray investigations, x-ray types, and
referral and attendance information for
clients attending the x-ray unit at Longton
Assertive Outreach Module It provides functionality to enable the team
members to act upon referrals received,
deciding whether or nor to accept the
The AOT Assertive Outreach team system referral and if accepted to record contact
provides functionality to enable CMS details against that referral.
clinicians to refer clients with whom
contact with the service has been lost to
the Assertive outreach Team
Child & Adolescent Mental Health Module Ensures relevant service information is
readily available for Commissioners
Reflects the workload of the Team, which
Recording specific and detailed activity includes time spent on both indirect and
against the client record to support both face to face activity
the Service itself and other practitioners Ensuring quick and simple access to
involved in the care of the client available information held about the young
To capture detailed diagnostic and person from one central option (In-Patient,
HoNOSCA scores against the patients Out Patient, Community Nursing, School
In-patient admission Nursing etc plus medication history /
A system that allows links to current information)
epidemiology data to help identify any
issues around preventative strategies
Violent Incidents Module Enabling the recording of incidents by type,
date & time and location, and persons
Provides for the central administration of
Violent Incidents for the mental Health and
Learning Disability Directorates
Page 43 of 51 North Staffordshire PCT IM&T Strategy v0.01
Inpatients Management Module (PMS) Register patients and book them onto a
Transfer patients from one ward to
This system is used to record the inpatient
spells and finished consultant episodes
(FCE’s) for Elderly Care and Mental Health Transfer patients from one consultant to
In-patients. It uses different maintenance another.
screens for some core functions, such as
Place a patient on ward leave.
patient demographics, and has different
user interface standards. Discharge patients.
Print KMR1 forms which have the diagnosis
written on them before being sent for
Enter diagnosis codes against episodes.
This task is carried out under contract by
the coding staff of the University Hospital
of North Staffordshire NHS Trust.
Run various reports.
Bed Management Module (BMS) This system allows for the setting up of the
number of beds by specialty, age group, sex
etc. on each ward.
This system records number of beds by
specialty, age group, sex etc. on each ward.
Elderly Care Liaison Module Staff may record an interest in a patient
episode and then add any contact details
for that episode. It also provides a display
The system records and reports the activity of recent community contacts, in-patient
details of Elderly Care staff. episodes and referral to a day hospital.
Genesys – Health Records Tracer Module The system enables staff to request notes
from the current location.
Page 44 of 51 North Staffordshire PCT IM&T Strategy v0.01
The GENESYS system provides for the
recording of information relating to the
whereabouts of client case notes,
Pressure Ulcer (Sore) Monitoring Module The system provides Management reports
giving staff the ability to monitor pressure
This system records the presence, site and
severity of in-patient pressure sores.
Discharge Coordination Module The system provides a quick lookup of
health service information and community
contact details for the selected patient.
The discharge co-ordinator may record an The system allows for more effective
interest in a mental health in-patient planning and potential to spot blockages
episode and record contact activities quickly.
against that episode.
Additional information about an in-patients
readiness to be discharged and reasons for
non-discharge is captured.
Brain Injuries Rehab Group Module The system records information about the
patient, type of head injury, and what
symptoms the client is experiencing.
The BIRG system provides a method of
recording statistical information relating to
head injuries. The symptoms are recorded
twice, firstly at an initial interview and
again at a follow-up interview. The
symptom types are pre-defined codes.
E-Works e-Work is a web based, Business Process Management Cancer 14 day Wait Referrals Improved clinical care as a result of
Platform technology that allows repeatable tasks to be The electronic transfer of urgent 14 day timely, accurate and complete patient
automated. It promotes greater efficiency, due to the wait referrals from General Practice to information.
elimination of administrative paper-based activity. the Cancer Referral Bureau (CRB) Increased use of the standardised
Page 45 of 51 North Staffordshire PCT IM&T Strategy v0.01
At the CRB, the application supports the referral and receipt summary
It utilises the concept of electronic workflow where process of booking patients into Increased speed of referral
Electronic Folders are moved through a process, from outpatient clinics and investigations Increased speed of receipt of
stage to stage, by different users. All users are able to track appointments information
the progress of the forms online, delivery is immediate, Improved data quality, in terms of
decisions can be made by the system without human legibility, accuracy and completeness
intervention and tasks requiring calculation can also be
Referrals do not lose legibility as can
done by the system.
happen with a fax copy
Improved information technology
systems to enhance the use of the
referral and receipt/appointment data
Referrals will be automatically stored as
they are received so minimizing the
chance they are mislaid
A referral can be sent instantaneously to
the CRB and an acknowledgement can
be sent back by the receiving computer
to say it has been received reducing
uncertainty for the GP and reassuring
Most relevant data needed for a referral
i.e. patient demographics is
automatically incorporated ensuring
accuracy and completeness
Rapid Access Chest Pain Clinic – electronic To achieve outpatient wait times
referral and discharge
Improved data quality
To prevent paperwork going astray
The electronic transfer of urgent 14 day
To speed up the discharge process
wait referrals from General Practice to
the Cardiology department at the local Increased speed of receipt of referral
acute trust (UHNS) Increase speed of receipt of discharge
The application supports the process of
booking patients into RACP clinics Partial integration of data into clinical
All clinical information collected from
the patients appointment is entered
onto the application
An electronic discharge letter is
automatically generated (based upon
Page 46 of 51 North Staffordshire PCT IM&T Strategy v0.01
the clinical information entered) and is
made available to General Practices for
Stoke Musculoskeletal Appointment Slot To effectively manage patients that do
Hospital Early Referral System not require surgery
(SMASHERS) Partial integration of data into clinical
In its current form, the application supports Improved data quality
the electronic transfer of SMASHERS To prevent paperwork going astray
Referrals (Orthopaedic, Rheumatology, Increased speed of receipt of referral
Musculoskeletal, acute back pain) referrals
from General Practices within Stoke PCT to
the patient choice and referral centre of
The application retains the functionality to
transfer these referrals electronically to the
local acute trust (from both PCTs) should
this service by required.
PCIS The system was designed in direct response to business PCIS provides an effective solution by Administration - Controls data entry onto
requirements, the system delivers management integrating data from several operational the system
information based on general practice data. systems and holding it in a data warehouse.
Storage needs are reduced and information Profiles - Provides profiles and reports
PCIS is a software tool that is able to unlock information is held only once, improving accuracy and about general medical practices and their
stored on a variety of databases. In particular, it opens up reliability. The data warehouse may then activity.
the wealth of detail about practices stored in the Exeter be accessed, by a variety of systems, for
system. analysis and reporting. Medical Directory - Production of a
directory of GP services in compliance
All the information within the PCIS system is based upon PCIS was developed in line with the with NHS regulations.
general medical practices. Practice-based data is not following strategic principles:
available directly from the core registration and payments Population - Provides access to
systems, which centre information on the individual GP All data must be accessible from any anonymous patient records for grouping
and partnerships. workstation by all trained officers, by, for example, Postcode, Age band, Sex,
subject only to the rules of GP, Practice or combinations of these.
confidentiality and data protection.
Management information must be fed Data Preparation - For merging two or
Page 47 of 51 North Staffordshire PCT IM&T Strategy v0.01
from operational systems using more sets of GP information into one.
controlled periodic and held ONLY
Information systems must be open,
using industry standards for maximum
availability and connectivity.
PCMIS PCMIS is a North Staffordshire wide information system PCMIS connects remotely to GP clinical Backup of Clinical System in the case of
which - systems extracts anonymised data via failure
Provides GP Practices and PCT’s with a wide range of NHSNet and stores it in a central database. Data can be acquired by the PCT remotely
information derived from anonymised data extracted with no time factor needed from the
from GP clinical systems. Access is given to: practice
Provides practices with access to a read only Electronic The practice via the EPR at patient level Sits in the background unobtrusively and
Patient Record via NHS net. Access is restricted to staff A limited number of analysts at an doesn’t interfere with day to day practice
that the practice have specified as requiring access to anonymised level activity
the patient record. This may be expanded in time, with The PCT at an aggregated level Information can be produced in a timely
approval from the practice, to include allied health (numbers only) when provided by the fashion
professionals, local walk-in centres, A&E and GP out of HIS. Practices are able to request ad-hoc reports
hours co-op. Practices get : from the HIS information team
The practices can make ad-hoc requests for
any information that can be derived from
the data. They can also view a read only
copy of patient information via the EPR.
Also, on asking, the practice may receive
copies of any audit reports requested by
The PCT’s can make ad-hoc requests for
aggregated (Numeric) data, e.g. number of
smokers per PCT.
COIN Centre of Interest Network Principal sites linked by LES 100 (100Mbit Major sites connected to the spine using
LAN extension services) to provide a high LES 2 and LES 10 (10Mbit) links to provide
bandwidth spine, supporting users running robust fixed links Provides secure and
centrally hosted applications remotely and enhanced communications between users
providing a high quality resilient core and applications.
capable of supporting voice over IP
telephony and videoconferencing
Page 48 of 51 North Staffordshire PCT IM&T Strategy v0.01
Appendix 4: Timeline for National Programme developments and likely impact on North Staffordshire PCT
Product Now Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Local Actions
1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4
20 20 20 20 20 20 20 20 20 20 20 20 20 20 20
2 07 07 07 08 08 08 08 09 09 09 09 10 10 10 10
Authentification (RA) Register new staff as they go to
Lorenzo. Maintain registration of
pharmacies /GPs etc.
Booking for diagnostics PCT to publish diagnostics service menu
on the choice menu
Booking for outpatients PCT to add homeopathy clinics to C&B
catalogue when service transfers to
CAB – Direct Booking Dependant on roll-out of UHNS iSoft
Clinical Record IM&T DES will prepare practices to
summary upload to spine. Need a local
implementation plan when the area is
invited to go live.
Electronic prescription R1 R Local project to continue to engage staff
service 2 and realise benefits of further releases.
Existing GP systems
Each will plan to move up the GPSOC levels over the next three years
GP 2 GP transfer EMIS EMIS M Dates indicated are nationally proposed
LV 5.2 PCS ic dates when suppliers will be ready. If
Web ro these dates achieved then North
In te Staffordshire will need to establish a roll
P st out programme.
Healthspace R2.1 R R2.3 Over the life of the strategy, North
Page 49 of 51 North Staffordshire PCT IM&T Strategy v0.01
Product Now Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Local Actions
1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4
20 20 20 20 20 20 20 20 20 20 20 20 20 20 20
2 07 07 07 08 08 08 08 09 09 09 09 10 10 10 10
2. Staffordshire will need to establish a
2 project to deliver.
N3 Largely complete locally managed by
the HIS in conjunction with COIN. New
premises need to be connected so links
with estates strategy are essential.
NHS UK PCT to be clear on its update
mechanisms for this existing service.
NHSmail HIS project to determine local economy
Personal demographic record summary Two milestones will determine changes
(SPINE) to child health service and the GP
patients registration service
QMAS Annual upgrades.
Secondary Uses Next major development relates to 18
Service week wait.
Child Health Future releases will give more links with
Lorenzo. Final child health system will
be fully integrated with Lorenzo v 4.0
Lorenzo (CRS) iPM LE2.2 Lorenzo Local implementation of iPM completed
by Dec 2008 for Community. As product
develops, local upgrades and
retraining/support will be applied once
PACS Implement viewing and diagnostic PC’s
in community hospitals
Page 50 of 51 North Staffordshire PCT IM&T Strategy v0.01
Appendix 5: Glossary
CAF Child assessment framework
CfH Connecting for Health
CHIPS Combined Healthcare Information Processing System
CSCA Computer Sciences Corporation. (north west’s LSP )
DES Directly enhanced service
DoH Department of Health
EMIS Egton Medical systems (GP system supplier)
EPR Electronic Patient record
GP2GP System of electronic transfer of data from GP system to GP system.
HSW Health Service Wales
IKM Information and knowledge management
IM&T Information Management and technology
IS Independent Sector
LDP Local delivery plan
LSP Local Service Provider
NCRS (or NCRS) National Care Record Service
NPfIT National Programme for Information technology
PACS Picture archiving communication system
PBC Practice based commissioning
PCT Primary Care Trust
QoF Quality and outcomes framework
RA Registration authority
RIS Radiology information system
RTT Referral to treatment time
SAP Single Assessment Process
StHA Strategic Health Authority
SUS Secondary Uses Service
TPP The Phoenix Partnership
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